1. Field of the Invention
The present invention relates to back supports for use during the emergency transport of patients to a medical facility following an actual or suspected spinal injury, and in particular relates to such supports that conform to the precise shape of an individual patient's back for support of the arched region of the spine.
2. Brief Description of the Related Art
Upon arrival at an accident scene, the first task of an emergency medical technician (EMT) or other first responder is to assess the condition of the injured person or persons. If a back or neck injury is indicated or suspected as a result of this assessment, the responder must take great care in loading the patient into an ambulance or other vehicle in order to avoid additional injury to the patient during loading or during transport to a medical facility. The typical practice is to place a cervical collar around the neck of the patient to hold the neck in place, and then the patient is transferred to a rigid back board and secured in place with straps. This prevents the patient from being moved or jostled during transport.
Although the cervical collar and back board do provide some support and protection for the patient, the spinal column is not perfectly straight, and thus the arched portions of the spine are not supported by the flat back board during transport. Each bump encountered by the ambulance or other vehicle during the transportation process will result in a deflection of the portion of the spine that is arched above the back board. Tests conducted by the inventor of the present invention have demonstrated that deflections due to railroad tracks, pot holes, rough gravel roads, and sudden dips in major highways may cause deflection in the arched area of the spine by as much as 0.35 inches. This deflection and repeated deflections may result in a furtherance of damage to the spinal column in a patient that has suffered a spinal column injury, and in the worst cases may result in permanent paralysis, where full support of the spinal column might have prevented the injury from being increased.
The prior art includes several efforts to provide for immobilization of various body parts during transport, although none of these solutions are entirely satisfactory for the application described above. For example, U.S. Patent Publication No. 2005/0033207 to Anders teaches an apparatus to immobilize an injured body part, such as the head/neck or a limb, which includes one or more flexible bags. With the apparatus placed in proximity to an injured body part, two precursor agents are mixed in the bags to produce a reaction that results in a foam that fills the bags. The foam solidifies in a short time to provide a solid support for the injured body part.
Although the Anders specification includes the assertion that the Anders device may be used to provide full cervical spine immobilization, the device actually provides only head immobilization without solid support for the arched portion of the spine when a patient is secured to a back board. In addition, the use of foam or other air-inflation techniques is not desirable for support of the spine because of the possibility of a lifting affect on an injured area of the spine. This may cause localized pressure that could result in further injury to a damaged spinal cord.
The prior art also includes several types of back supports that are intended to conform to the shape of the spine, although none are intended for immobilization of a patient during transport. U.S. Pat. No. 4,475,543 to Brooks et al. teaches a back brace comprising a wide elastic belt and a pouch at the spine. The pouch contains a bag that may be filled with a curable foam, which conforms to the shape of the patient's back and hardens in place. Similarly, U.S. Pat. Nos. 5,437,614 and 5,632,723 to Grim teach a back support with one or more bag inserts that contains a urethane pre-polymer matrix. Water is injected into the bags, which results in a hardening of the matrix into a shape that conforms to the wearer. Each of these devices are intended to provide support during walking, not for securing the spine in an immobilized state during transport of a patient with an actual or suspected spinal injury.
In addition to the limitations already noted, it may be seen that each of the prior art devices are rather complex, requiring various adhesives, straps, belts, or the like to hold them in place. The proper placement of such devices will require a significant amount of time, which would delay transport of a patient to a medical facility during an emergency situation. Since even a few seconds may be critical to a patient's survival and recovery, such devices are not practical for emergency response applications. The limitations of the prior art are overcome by the present invention as described below.